Provider Demographics
NPI:1407886468
Name:MARKWELL, GENIE M (DC)
Entity Type:Individual
Prefix:DR
First Name:GENIE
Middle Name:M
Last Name:MARKWELL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19987 1ST AVE S STE 102
Mailing Address - Street 2:
Mailing Address - City:NORMANDY PARK
Mailing Address - State:WA
Mailing Address - Zip Code:98148-2400
Mailing Address - Country:US
Mailing Address - Phone:206-824-7200
Mailing Address - Fax:206-832-4652
Practice Address - Street 1:19987 1ST AVE S STE 102
Practice Address - Street 2:
Practice Address - City:NORMANDY PARK
Practice Address - State:WA
Practice Address - Zip Code:98148-2400
Practice Address - Country:US
Practice Address - Phone:206-824-7200
Practice Address - Fax:206-832-4652
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034082111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8861594Medicare UPIN